Client Financial Information

The Client Financial screen enables you to enter financial, billing, and insurance information for a client. Some of the fields on this screen are common with fields on the Client Add screen. Information for these fields can be added or updated from either screen.

Objectives

After completing this section, you will be able to:

Enter financial information for a client
Enter billing information for a client
Enter insurance information for a client
Identify fields that are common to both the Client Add and Client Financial screens

From this screen, you are able to access the following buttons:

Financial (Hot Key = Alt + F) takes you to the Financial and Billing Sections of this screen
Insurance (Hot Key = Alt + I) takes you to the Insurance Section of this screen
Save (Hot Key = Alt + S) saves the record and returns you to the Selected Client screen.
Exit (Hot Key = Alt + X) discards any changes made and returns you to the Selected Client screen.

Field Descriptions

Financial Section

Field	Description
Number in Household	Total number of people living together in the same household. Any unborn children are included in the total, if appropriate. Automatically filled in with 1.
Monthly Income	Monthly gross income earned by all members of the household. Default value is 0.
Percent Poverty	Read-only. Automatically filled in with the calculated poverty percentage. Calculated using the Poverty Table to match the number of people in the household and the monthly gross income of the household. If Number in Household and Income are not filled in, the Percent Poverty will default to 0%.
Marital Status	Marital status of the client. Select from a pull-down list. Defaults to Unknown unless the client is less than 13 years old. In this case, the default is Never Married. Note: For a new client, the marital status default is “Unknown” in the database. Therefore, if the client is less than 13 and the pull-down defaults to Never Married, then you will be prompted to save the status when you exit the screen. (This is especially important for Primary Health Care.)
Employment Status	Employment status of the client. Select from a pull-down list. Defaults to Unknown
Education Level	Education level of the client. Select from a pull-down list. Defaults to Not Specified.

Billing Section

Field	Description
Primary Coverage	The primary insurance coverage for the client. Select from a pull-down list.
Medicaid Eligible	Indication of client’s Medicaid eligibility status. Select from a pull-down list. Options are Yes, No, or Pending. Default is Pending. (Also on Client Add screen.)
Medicaid #	Medicaid number for the client. This field is only accessible if Medicaid Eligible is set to Yes. If there is an existing Medicaid number and Medicaid Eligible is set to Pending, the field will be grayed out but not cleared. If Medicaid Eligible is set to No, the field will be grayed out and cleared. (Also on Client Add screen.)
Eligible Date	(Required field if there is a Medicaid number) Date that the client becomes eligible for Medicaid. This field is only accessible if there is a Medicaid number. If there is an existing eligibility date and Medicaid Eligible is set to Pending, the field will be grayed out but not cleared. If Medicaid Eligible is set to No, the field will be disabled and cleared. (Also on Client Add screen.)
Title V	Checkbox indicating whether client is eligible for Title V.
Title V Eligible Date	Date that the client becomes eligible for Title V. This field will be grayed out until you check Title V. If you uncheck Title V and there is an existing date, this field will be grayed out but not cleared. Also, if the primary coverage is Medicaid, the Title V checkbox will be unchecked and the eligible date will be grayed out but not cleared.
Title 20	Checkbox indicating whether the client is eligible for Title 20.
Title 20 Eligible Date	Date that the client becomes eligible for Title 20. This field will be grayed out until you check Title 20. If you uncheck Title 20 and there is an existing date, this field will be grayed out but not cleared. Also, if the primary coverage is Medicaid, the Title 20 checkbox will be unchecked and the eligible date will be grayed out but not cleared.
Title 20 #	This field will be grayed out until you check Title 20. If you uncheck Title 20 and there is an existing number, this field will be grayed out but not cleared. Also, if the primary coverage is Medicaid, the Title 20 checkbox will be unchecked and the Title 20 number will be grayed out but not cleared.
TH Steps/EPSDT	Checkbox indicating whether client is eligible for EPSDT.
Medicare #	Client’s Medicare number. Must be a nine-digit number.
Part A or B	Indication of whether Medicare covers Part A, Part B, or both. Select from a pull-down list. Not accessible until Medicare number is entered.
WIC #	Client’s WIC number
PC Screened	Client’s eligibility status for Primary Health Care. Select from a pull-down list.
PC Screen Date	Date the client was screened for Primary Health Care.
PC Screen Site	Site where the client was screened. Select from a pull-down list.
Billing Last Name	(Required Field) Defaults to client last name but can be overwritten
Billing First Name	(Required Field) Defaults to client first name but can be overwritten
Billing MI	Defaults to client middle initial but can be overwritten
Billing DOB	(Required Field) Defaults to client DOB but can be overwritten

Insurance Section

Field	Description
Insured ID #	Insurance policy number
Insured Name	Name of person holding the insurance policy
Address (Insured)	Address of person holding the insurance policy
City (Insured)	City of residence for policy holder
State (Insured)	State of residence for policy holder. Default is “TX”. Select from a pull-down list.
Zip Code (Insured)	Zip code for residence of policy holder. Must be five or nine digits.
Phone (Insured)	Phone number for policy holder including prefix and area code. Prefix must be 0,1, or left blank. Area Code must be 3 digits or left blank. Phone number must be 7 digits.
Date of Birth (Insured)	Date of birth for policy holder. Must be a valid date format after 01/01/1850 and on or before the current date.
Sex (Insured)	Gender of policy holder.
Relation to Client	Relationship between policy holder and client. Select from a pull-down list.
Ins. Plan/Program	Name of insurance company or program
Policy Group/FECA #	Policy group number or FECA number
Employer/School	Employer or school through which insurance is issued.
Primary Care Provider	Name of primary care provider for the client
Provider ID #	Performing provider number
Address (Provider)	Address of provider
City (Provider)	City where provider is located
State (Provider)	State where provider is located. Default is “TX”. Select from a pull-down list.
Zip Code (Provider)	Zip code for location of provider. Must be five or nine digits.